MEDICARE: PIEDMONT HEALTHCARE FOR WOMEN P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1790820215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIEDMONT HEALTHCARE FOR WOMEN P.A.

Provider Business Mailing Address
First Line	:	301 E WENDOVER AVE STE 400
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1207
Country	:	US
Telephone Number	:	336-286-6565
Fax Number	:	336-286-6566

Provider Business Practice Location Address
First Line	:	301 E WENDOVER AVE STE 400
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1207
Country	:	US
Telephone Number	:	336-286-6565
Fax Number	:	336-286-6566

Authorized Official
Title or Position	:	MD
Name	:	JOHN S MCCOMB
Credential	:	MD
Telephone Number	:	336-286-6565

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	08/02/2010

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